Alcohol intoxication and post-burn complications
Alcohol intoxication and post-burn complications
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DOI：
10.2741/1857
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发表时间：
2006-01-01
影响因子：
3.1
通讯作者：
Chaudry, IH
中科院分区：
文献类型：
--
作者：
Choudhry, MA;Chaudry, IH
本文讨论的研究结果表明，酒精 (EtOH) 中毒是一个主要的公共卫生问题。虽然损伤和乙醇中毒相互独立的影响已被详细研究，但只有少数研究评估了乙醇中毒和烧伤联合损伤对宿主防御的影响。对临床环境中进行的研究的分析表明，中毒患者需要频繁插管、伤口愈合延迟和住院时间更长。此外，与没有乙醇中毒的情况下受伤的患者相比，这些患者的死亡风险更大。另一方面，有一些研究并不支持这一观点。实验模型中获得的结果清楚地表明，烧伤前的急性乙醇中毒会损害宿主防御并增加感染的易感性。此外，我们实验室的实验数据还表明，烧伤前的乙醇中毒会抑制肠道免疫防御，损害肠道屏障功能并增加细菌生长。这会导致乙醇中的细菌移位和烧伤增加。此外，据报道，乙醇中毒和烧伤联合损伤后，心脏功能也会下降。总而言之，这些研究结果表明，烧伤前的乙醇中毒会降低宿主的抵抗力，导致感染的易感性增加。此外，与没有乙醇存在的情况相比，在有乙醇存在的情况下受伤的烧伤和外伤患者感染并发症的发生率更高，这表明受伤时乙醇中毒是一个危险因素。因此，烧伤/外伤患者入院急诊室时应监测血液乙醇浓度。
Results from the studies discussed in this article suggest that alcohol ( EtOH) intoxication is a major public health problem. While the effects of injury and EtOH intoxication independent of each other have been studied in detail, only few studies have evaluated the effect of a combined insult of EtOH intoxication and burn injury on host defense. An analysis of the studies conducted in the clinical setting suggests that intoxicated patients require frequent intubations, experience delayed wound healing and longer hospital stay. Furthermore, there is a greater risk of mortality in these patients compared to those who sustained injuries in the absence of EtOH intoxication. On the other hand, there are a few studies that do not support this notion. The results obtained in experimental models clearly suggest that acute EtOH intoxication before burn injury impairs host defense and increases susceptibility to infection. Additionally, experimental data from our laboratory also indicate that EtOH intoxication before burn injury suppresses intestinal immune defense, impairs gut barrier functions and increases bacterial growth. This results in increased bacterial translocation in EtOH and burn injury. In addition, a decrease in cardiac function is also reported following a combined insult of EtOH intoxication and burn injury. Altogether, these findings suggest that EtOH intoxication before burn injury diminishes host resistance resulting in increased susceptibility to infection. Moreover, the findings of a higher incidence of infectious complications in burn and trauma patients who sustained injury in the presence of EtOH compared to those in its absence suggest that EtOH intoxication at the time of injury is a risk factor. Therefore blood EtOH should be monitored in burn/trauma patients at the time of admission in the emergency room.